Neuroprosthetics to support impaired hand functions: A multidisciplinary approach combining brain-machine interfaces and wearable exoskeletons

Neuroprosthetics, the discipline that aims at interfacing neural systems to artificially engineered devices, has witnessed in recent years important advancements towards the ultimate goal of augmenting and restoring human functions through technology and artificial systems.

Research in this field covers a wide range of efforts, from advancing our basic understanding of the neural processes involved into human sensory, motor and cognitive functions, to developing artificial intelligence algorithms for their decoding, to the physical interfacing between artificial devices and the human nervous system and biomechanics. Ultimately, this discipline aims at fusing these systems in order to restore, replace and rehabilitate lost and impaired functions due to motor disabling conditions or traumatic accidents.

In this thesis, I present a multidisciplinary approach that aimed at developing a neuroprosthesis for the assistance and restoration of hand functions impaired by neurological disorders or traumatic accidents, such as cerebrovascular accidents and spinal cord injuries. These efforts encompassed the conceptualization and development of a robotic hand exoskeleton and brain-machine interface (BMI) algorithms for its control. Specifically, this thesis focused on the design, development and testing of (i) a novel mechatronic hand exoskeleton to assist hand motions within domestic and clinical settings, (ii) non-invasive BMI approaches based on electroencephalography (EEG) to decode neural correlates of intended hand movements, and on (iii) the closed-loop integration of the proposed exoskeleton and BMI for the sake of providing continuous feedback about ongoing neural modulations through hand motions and to trigger sensorimotor rehabilitation within clinical scenarios.

Results showed that the proposed mechatronic system can successfully control hand opening and closing within a fully wearable, portable and lightweight package. The system was tested with users who suffered from motor disabling impairments, showing that it could help them in performing several activities of daily living for the first time since their accidents. From a brain-machine interfacing perspective, this work shows how imagined hand movements can be decoded, through EEG, in parallel with exoskeleton-induced motions, with important implications for the development of more embodied human-machine interaction protocols. Finally, this work shows how the closed-loop control of exoskeleton motions by means of the decoded ongoing neural activity enhances the discriminability of sensorimotor neural patterns and improves the performance of the brain-machine control channel.

Overall, the results presented here represent important advancements within the field of neuroprosthetics, with interesting implications for the development of assistive exoskeletal technologies and non-invasive brain-machine interfaces aimed at controlling such systems in clinical or domestic settings, for both assistive and neurorehabilitative purposes.